An implementation project to expand access to self-administered depot medroxyprogesterone acetate (DMPA)
An implementation project to expand access to self-administered depot medroxyprogesterone acetate (DMPA)
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DOI：
10.1016/j.contraception.2020.09.001
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发表时间：
2020-12-01
期刊：
影响因子：
2.9
通讯作者：
Karlin, Jennifer
中科院分区：
文献类型：
--
作者：
Katz, Micah;Newmark, Rebecca L.;Karlin, Jennifer
目的：描述一个积极主动的患者外展项目的实施和结果，该项目为加州一家安全网诊所的感兴趣的患者提供自我管理的甲羟孕酮(DMPA)皮下注射(SC)。研究设计：我们联系了一家城市安全网医院的初级保健诊所的非怀孕患者，他们在过去一年里一直服用DMPA肌肉注射(IM)，以评估他们对自我管理的DMPA-SC的兴趣。感兴趣的患者收到了DMPA-SC的处方，并与诊所提供者预约了远程健康，以学习自我注射。我们记录了患者对DMPA-SC的兴趣，完成了预约，并完成了首次注射。结果：在90例符合条件的患者(年龄17~54岁)中，我们成功地与70例(78%)DMPA-SC进行了联系和讨论。26名患者(37%)表达了对DMPA-SC的兴趣，并安排了远程医疗预约，以学习自我给药。有兴趣的人中有15人(58%)(占总数的21%)成功地自我注射了DMPA-SC。在对DMPA-SC不感兴趣的44例患者中，最常见的3个原因是害怕自我注射(n=23[52%])、想要停止DMPA(n=11[25%])和对DMPA-IM满意(n=6[14%])。结论：在城市安全网医院为基础的初级保健诊所中，最近一年使用DMPA-IM的患者有兴趣并成功地启动了自用DMPA-SC。(C)2020 Elsevier Inc.保留所有权利。
Objective: To describe the implementation and results of a proactive patient outreach project to offer selfadministered, depot medroxyprogesterone (DMPA) subcutaneous (SC) to interested patients at a California safety-net clinic following expanded state Medicaid coverage.Study design: We contacted non-pregnant patients at an urban, safety-net hospital-based primary care clinic who had been prescribed DMPA intramuscular (IM) in the past year to gauge interest in selfadministered DMPA-SC. Interested patients received a prescription for DMPA-SC and a telehealth appointment with a clinic provider to learn self-injection. We recorded patient interest in DMPA-SC, completed appointments, and completed first injections. We conducted initial outreach in May, 2020 and recorded appointment attendance and completed injections through August, 2020.Results: Of 90 eligible patients (age 17-54), we successfully contacted and discussed DMPA-SC with 70 (78%). Twenty-six (37%) patients expressed interest in DMPA-SC and scheduled telehealth appointments to learn to self-administer the medication. Fifteen (58%) of those interested (21% of the total) successfully self-injected DMPA-SC. Of the 44 (63%) patients not interested in DMPA-SC, the three most common reasons were fear of self-injection (n = 23 [52%]), wanting to stop DMPA (n = 11 [25%]), and satisfaction with DMPA-IM (n = 6 [14%]).Conclusion: There is interest in and successful initiation of self-administered DMPA-SC among patients at an urban safety net hospital-based primary care clinic who have used DMPA-IM in the last year. (C) 2020 Elsevier Inc. All rights reserved.